Summary

for people ages 18 years and up (full criteria)
study started
estimated completion:

Description

Summary

This study will determine the effectiveness of tele-psychology in treating persons with spinal cord injury (SCI) with depressed mood in the early period post-rehabilitation discharge. Depression among individuals with SCI is the most common psychological condition following an injury; 22% of civilians with SCI and 28% of veterans with SCI experience depression after injury, which is higher than the able-bodied population (Williams 2015; Ullrich 2014). Individuals with SCI face many barriers in receiving psychotherapy, such as lack of accessible transportation, unfamiliarity with community resources, or stigma associated with seeking treatment for depression, which this project aims to address. Cognitive behavior therapy (CBT), which helps people develop different ways of thinking and behaving to reduce their psychological distress, will be provided via iPad FaceTime by a psychologist with expertise in working with persons with SCI. The objectives of the proposed project are to reduce depressive symptoms, decrease associated symptoms of anxiety, and to improve satisfaction with life with CBT provided via tele-psychology. The secondary objective is to show intermediate efficacy of tele-psychology in persons with SCI with depressed mood.

Official Title

Telepsychology Intervention for Individuals With Spinal Cord Injury and Depression

Details

  1. Rationale / Objectives This study will determine the effectiveness of tele-psychology in treating persons with spinal cord injury (SCI) with depressed mood in the early period post-rehabilitation discharge. Depression among individuals with SCI is the most common psychological condition following an injury; 22% of civilians with SCI and 28% of veterans with SCI experience depression after injury, which is higher than the able-bodied population (Williams 2015; Ullrich 2014). Individuals with SCI face many barriers in receiving psychotherapy, such as lack of accessible transportation, unfamiliarity with community resources, or stigma associated with seeking treatment for depression, which this project aims to address. Cognitive behavior therapy (CBT), which helps people develop different ways of thinking and behaving to reduce their psychological distress, will be provided via iPad FaceTime by a psychologist with expertise in working with persons with SCI.

The objectives of the proposed project are to reduce depressive symptoms, decrease associated symptoms of anxiety, and to improve satisfaction with life with CBT provided via tele-psychology. The secondary objective is to show intermediate efficacy of tele-psychology in persons with SCI with depressed mood.

II. Impact CBT via iPad FaceTime is expected to be a convenient and effective treatment for depression after SCI with short-term (14-week post-discharge) and intermediate (26-week post-discharge) benefits. This project would impact individuals with SCI, post-discharge from acute rehabilitation, through the provision of an innovative treatment for depression, easing the transition back to their home and community. Furthermore, CBT treatment will be provided in the comfort and privacy of the participant's home, therefore combating stigma, as well as physical and transportation-associated barriers. CBT via FaceTime does pose a potential confidentiality risk, but the study team will stress that both parties choose a location (i.e. private office for the psychologist and a private room at home for the participant) that will minimize this risk. Prior studies have shown a beneficial effect of CBT provided with tele-psychology among other populations. Telemedicine is rapidly advancing within the field of medicine; however, its impact on persons with SCI and the use of tele-psychology are not yet widespread. This proposed study aims to close this gap and can determine whether CBT via iPad improves mood and quality of life (as measured by satisfaction with life) and can assess if tele-psychology is an effective and replicable method for providing psychological care. With evidence from this study elucidating the effectiveness of tele-psychology utilizing rapidly advancing technology, tele-psychology for individuals with SCI may become as usual and routine as in-person psychological treatment within several years.

III. Contribution This project provides an innovative approach to treating depression and an exciting opportunity to understand the treatment effects of our proposed tele-psychological intervention for individuals with SCI. CBT treatment provided via iPad FaceTime tele-psychology for depression is a novel approach that can easily be disseminated to other SCI centers and community hospitals. Hence, medical teams will have an alternative option to consider during the discharge planning stages of rehabilitation and during their transition to home.

Keywords

Spinal Cord Injuries Depression telepsychology cognitive behavioral therapy Wounds and Injuries Depressive Disorder

Eligibility

You can join if…

Open to people ages 18 years and up

Pre-screening Inclusion Criteria:

  • Adults 18 years or older with traumatic or non-traumatic SCI at any level of injury.
  • Individuals with acute SCI being discharged from the acute inpatient rehabilitation unit to a residence in the state of California.
  • Able to understand and speak English fluently.
  • Possess adequate decision-making capacity to provide independent informed consent
  • Within one year of date of injury.

Tele-psychology Inclusion Criteria:

  • Mild to moderate depression (PHQ-9 total score between 5-14)

You CAN'T join if...

Pre-screening Exclusion Criteria:

  • Medically unstable as determined by the subject's treating physician (e.g. pneumonia)
  • Acute psychosis
  • Persons who are incapable of giving informed consent
  • Being discharged to a facility other than home (e.g., Skilled Nursing Facility)
  • Inability to comprehend written or oral English

Tele-psychology Exclusion Criteria:

Subjects will be excluded if:

  • Minimal Depression (PHQ-9 total score < 5)
  • Severe Depression (PHQ-9 total score > 14)
  • They endorse suicidality on the PHQ-9
  • They are determined to have moderate-severe cognitive deficits as screened by the Montreal Cognitive (MoCA ≤ 25)

Details

Status
not yet accepting patients
Start Date
Completion Date
(estimated)
Sponsor
Santa Clara Valley Health & Hospital System
Links
Rehabilitation Research Center
ID
NCT03711760
Study Type
Interventional
Last Updated